Myocardial infarction, ST-elevation and non-ST-elevation myocardial infarction and modelled daily pollution concentrations; a case-crossover analysis of MINAP data

Objectives: To investigate associations between daily concentrations of air pollution and myocardial infarction (MI), ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI). Methods: Modelled daily ground-level gaseous, total and speciated particulate pollutant concentrations and ground-level daily mean temperature, all at 5 km x 5 km horizontal resolution, were linked to 202,550 STEMI and 322,198 NSTEMI events recorded on the England and Wales Myocardial Ischaemia National Audit Project (MINAP) database. The study period was 2003-2010. A case-crossover design was used, stratified by year, month, and day of the week. Data were analysed using conditional logistic regression, with pollutants modelled as unconstrained distributed lags 0-2 days. Results are presented as percentage change in risk per 10 µg/m3 increase in the pollutant relevant metric, having adjusted for daily mean temperature, public holidays, weekly flu consultation rates, and a sine-cosine annual cycle. Results: There was no evidence of an association between MI or STEMI and any of O3, NO2, PM2.5, PM10 or selected PM2.5 components (sulphate and elemental carbon). For NSTEMI there was a positive association with daily maximum 1-hour NO2 (0.27% (95% CI: 0.01 to 0.54)), which persisted following adjustment for O3 and adjustment for PM2.5. The association appeared to be confined to the midland and southern regions of England and Wales. Conclusions: The study found no evidence of an association between the modelled pollutants (including components) investigated and STEMI but did find some evidence of a positive association between NO2 and NSTEMI. Confirmation of this association in other studies is required

Spatiotemporal evaluation of EMEP4UK-WRF v4.3 atmospheric chemistry transport simulations of health-related metrics for NO2, O3, PM10 and PM2.5 for 2001-2010

This study was motivated by the use in air pollution epidemiology and health burden assessment of data simulated at 5 km  ×  5 km horizontal resolution by the EMEP4UK-WRF v4.3 atmospheric chemistry transport model. Thus the focus of the model–measurement comparison statistics presented here was on the health-relevant metrics of annual and daily means of NO2, O3, PM2. 5, and PM10 (daily maximum 8 h running mean for O3). The comparison was temporally and spatially comprehensive, covering a 10-year period (2 years for PM2. 5) and all non-roadside measurement data from the UK national reference monitor network, which applies consistent operational and QA/QC procedures for each pollutant (44, 47, 24, and 30 sites for NO2, O3, PM2. 5, and PM10, respectively). Two important statistics highlighted in the literature for evaluation of air quality model output against policy (and hence health)-relevant standards – correlation and bias – together with root mean square error, were evaluated by site type, year, month, and day-of-week. Model–measurement statistics were generally better than, or comparable to, values that allow for realistic magnitudes of measurement uncertainties. Temporal correlations of daily concentrations were good for O3, NO2, and PM2. 5 at both rural and urban background sites (median values of r across sites in the range 0.70–0.76 for O3 and NO2, and 0.65–0.69 for PM2. 5), but poorer for PM10 (0.47–0.50). Bias differed between environments, with generally less bias at rural background sites (median normalized mean bias (NMB) values for daily O3 and NO2 of 8 and 11 %, respectively). At urban background sites there was a negative model bias for NO2 (median NMB  =  −29 %) and PM2. 5 (−26 %) and a positive model bias for O3 (26 %). The directions of these biases are consistent with expectations of the effects of averaging primary emissions across the 5 km  ×  5 km model grid in urban areas, compared with monitor locations that are more influenced by these emissions (e.g. closer to traffic sources) than the grid average. The biases are also indicative of potential underestimations of primary NOx and PM emissions in the model, and, for PM, with known omissions in the model of some PM components, e.g. some components of wind-blown dust. There were instances of monthly and weekday/weekend variations in the extent of model–measurement bias. Overall, the greater uniformity in temporal correlation than in bias is strongly indicative that the main driver of model–measurement differences (aside from grid versus monitor spatial representivity) was inaccuracy of model emissions – both in annual totals and in the monthly and day-of-week temporal factors applied in the model to the totals – rather than simulation of atmospheric chemistry and transport processes. Since, in general for epidemiology, capturing correlation is more important than bias, the detailed analyses presented here support the use of data from this model framework in air pollution epidemiology

Mutation Symmetries in BPS Quiver Theories: Building the BPS Spectra

We study the basic features of BPS quiver mutations in 4D $\mathcal{N}=2$ supersymmetric quantum field theory with $G=ADE$ gauge symmetries.\ We show, for these gauge symmetries, that there is an isotropy group $\mathcal{G}_{Mut}^{G}$ associated to a set of quiver mutations capturing information about the BPS spectra. In the strong coupling limit, it is shown that BPS chambers correspond to finite and closed groupoid orbits with an isotropy symmetry group $\mathcal{G}_{strong}^{G}$ isomorphic to the discrete dihedral groups $Dih_{2h_{G}}$ contained in Coxeter$(G)$ with $$ the Coxeter number of G. These isotropy symmetries allow to determine the BPS spectrum of the strong coupling chamber; and give another way to count the total number of BPS and anti-BPS states of $\mathcal{N}=2$ gauge theories. We also build the matrix realization of these mutation groups $\mathcal{G}_{strong}^{G}$ from which we read directly the electric-magnetic charges of the BPS and anti-BPS states of $\mathcal{N}=2$ QFT$_{4}$ as well as their matrix intersections. We study as well the quiver mutation symmetries in the weak coupling limit and give their links with infinite Coxeter groups. We show amongst others that $\mathcal{G}_{weak}^{su_{2}}$ is contained in ${GL}({2,}\mathbb{Z})$; and isomorphic to the infinite Coxeter ${I_{2}^{\infty}}$. Other issues such as building $\mathcal{G}$ and $\mathcal{G}_{weak}^{su_{3}}$ are also studied.Comment: LaTeX, 98 pages, 18 figures, Appendix I on groupoids adde

Expanding role of the internet in the orthopaedic outpatient setting

The number of patients requiring review after joint arthroplasty is increasing. With an ageing population, increasing expectations from patients, and improved diagnostic methods and treatments, the demand for these procedures will also increase.1 The Department of Orthopaedic Surgery at Royal Devon and Exeter Hospital (Exeter, UK) started to experience a backlog of long-term arthroplasty patients requiring follow-up owing to limited outpatient resources and clinical staff. This scenario led us to think about other ways of reviewing these patients and to explore the feasibility of ‘virtual’ follow-ups. In 2002, Gupte and colleagues reviewed Internet use in the setting of orthopaedic outpatient clinics. They investigated the: (i) prevalence of Internet use; (ii) perception of the quality of medical information provided by the Internet; (iii) future intentions and attitudes towards Internet-based consultations.2 Their study showed promising data about the potential use of Internet-based follow-up, concluding that more than half of the patients evaluated were willing to access the Internet for medical information, with younger patients more likely to do so. Moreover, a significant proportion of respondents were willing to undergo an Internet-based consultation. The decade between the study by Gupte and colleagues and the present study has seen huge expansion in the use and availability of the Internet in the domestic setting. In 2002, a poll by the UK Office of National Statistics (ONS) concluded that 46% of UK households had an Internet connection. In 2011, ONS data showed that 77% of UK homes had an active internet connection.3 This rise has continued and, in 2014, 84% of individuals used the internet and 76% of adults accessed the internet each day.4 In addition, the way in which individuals access the internet is evolving, with 45% of internet users now accessing it via mobile devices. An estimated 6 million people accessed the internet via a mobile device for the first time in 2011.3 With the huge growth in internet availability in the past decade, we aimed to: (i) ascertain how use, attitudes and perceptions of the internet have changed over this time; (ii) explore potential uses and problems of internet follow-up in a patient cohort; (iii) ascertain if patients had access to an email account and, if so, would consider using an email-based questionnaire on follow-up; (iv) discover if individuals who did not have direct access to the internet had friends or relatives who did, and whether they would be willing to engage in follow-up by ‘proxy’.This article is freely available via Open Access. Click on the Additional Link above to access the full-text via the publisher's site

The effect of distance on reaction time in aiming movements

Target distance affects movement duration in aiming tasks but its effect on reaction time (RT) is poorly documented. RT is a function of both preparation and initiation. Experiment 1 pre-cued movement (allowing advanced preparation) and found no influence of distance on RT. Thus, target distance does not affect initiation time. Experiment 2 removed pre-cue information and found that preparing a movement of increased distance lengthens RT. Experiment 3 explored movements to targets of cued size at non-cued distances and found size altered peak speed and movement duration but RT was influenced by distance alone. Thus, amplitude influences preparation time (for reasons other than altered duration) but not initiation time. We hypothesise that the RT distance effect might be due to the increased number of possible trajectories associated with further targets: a hypothesis that can be tested in future experiments

Uncertainties in projecting climate-change impacts in marine ecosystems

Projections of the impacts of climate change on marine ecosystems are a key prerequisite for the planning of adaptation strategies, yet theyare inevitablyassociated withuncertainty.Identifying,quantifying,andcommunicatingthisuncertaintyis keytobothevaluatingtherisk associated with a projection and building confidence in its robustness. Wereview howuncertainties in such projections are handled in marine science. We employan approach developedin climatemodelling by breaking uncertainty down into(i) structural (model) uncertainty,(ii) initialization and internalvariabilityuncertainty,(iii)parametricuncertainty,and(iv)scenariouncertainty.Foreachuncertaintytype,wethenexaminethecurrent state-of-the-art in assessing and quantifying its relative importance. We consider whether the marine scientific community has addressed these types of uncertainty sufficiently and highlight the opportunities and challenges associated with doing a better job. We find that even within a relatively small field such as marine science, there are substantial differences between subdisciplines in the degree of attention given to each type of uncertainty. We find that initialization uncertainty is rarely treated explicitly and reducing this type of uncertainty may deliver gainsontheseasonal-to-decadaltime-scale.Weconcludethatallpartsofmarinesciencecouldbenefitfromagreaterexchangeofideas,particularly concerningsuchauniversalproblemsuchasthetreatmentofuncertainty.Finally,marinescienceshouldstrivetoreachthepointwherescenario uncertainty is the dominant uncertainty in our projections

Spontaneous retropharyngeal haematoma: a case report

<p>Abstract</p> <p>Introduction</p> <p>Spontaneous retropharyngeal haematoma is an unusual condition. It has multiple aetiological factors and can present to a number of specialists including the otolaryngologist.</p> <p>Case presentation</p> <p>We describe a case of spontaneous retropharyngeal haematoma which demonstrates the dramatic presentation and emphasises the need for a conservative approach.</p> <p>Conclusion</p> <p>It is important to be aware of this unusual condition with its distinct presentation. Surgical intervention should be resisted unless a treatable aetiological factor is found or airway compromise occurs. Most cases will resolve with conservative management.</p

Vertical zonation of testate amoebae in the Elatia Mires, northern Greece : palaeoecological evidence for a wetland response to recent climate change or autogenic processes?

The Elatia Mires of northern Greece are unique ecosystems of high conservation value. The mires are climatically marginal and may be sensitive to changing hydroclimate, while northern Greece has experienced a significant increase in aridity since the late twentieth century. To investigate the impact of recent climatic change on the hydrology of the mires, the palaeoecological record was investigated from three near-surface monoliths extracted from two sites. Testate amoebae were analysed as sensitive indicators of hydrology. Results were interpreted using transfer function models to provide quantitative reconstructions of changing water table depth and pH. AMS radiocarbon dates and 210Pb suggest the peats were deposited within the last c. 50 years, but do not allow a secure chronology to be established. Results from all three profiles show a distinct shift towards a more xerophilic community particularly noted by increases in Euglypha species. Transfer function results infer a distinct lowering of water tables in this period. A hydrological response to recent climate change is a tenable hypothesis to explain this change; however other possible explanations include selective test decay, vertical zonation of living amoebae, ombrotrophication and local hydrological change. It is suggested that a peatland response to climatic change is the most probable hypothesis, showing the sensitivity of marginal peatlands to recent climatic change

Switching of magnetic domains reveals evidence for spatially inhomogeneous superconductivity

The interplay of magnetic and charge fluctuations can lead to quantum phases with exceptional electronic properties. A case in point is magnetically-driven superconductivity, where magnetic correlations fundamentally affect the underlying symmetry and generate new physical properties. The superconducting wave-function in most known magnetic superconductors does not break translational symmetry. However, it has been predicted that modulated triplet p-wave superconductivity occurs in singlet d-wave superconductors with spin-density wave (SDW) order. Here we report evidence for the presence of a spatially inhomogeneous p-wave Cooper pair-density wave (PDW) in CeCoIn5. We show that the SDW domains can be switched completely by a tiny change of the magnetic field direction, which is naturally explained by the presence of triplet superconductivity. Further, the Q-phase emerges in a common magneto-superconducting quantum critical point. The Q-phase of CeCoIn5 thus represents an example where spatially modulated superconductivity is associated with SDW order

Microstructural evolution in solution heat treatment of gas- atomised Al alloy (7075) powder for cold spray

Cold gas dynamic spray is being explored as a repair technique for high-value metallic components, given its potential to produce pore and oxide-free deposits of between several micrometers and several millimeters thick with good levels of adhesion and mechanical strength. However, feedstock powders for cold spray experience rapid solidification if manufactured by gas atomization and hence can exhibit non-equilibrium microstructures and localized segregation of alloying elements. Here, we used sealed quartz tube solution heat treatment of a precipitation hardenable 7075 aluminum alloy feedstock to yield a consistent and homogeneous powder phase composition and microstructure prior to cold spraying, aiming for a more controllable heat treatment response of the cold spray deposits. It was shown that the dendritic microstructure and solute segregation in the gas-atomized powders were altered, such that the heat-treated powder exhibits a homogeneous distribution of solute atoms. Micro-indentation testing revealed that the heat-treated powder exhibited a mean hardness decrease of nearly 25% compared to the as received powder. Deformation of the powder particles was enhanced by heat treatment, resulting in an improved coating with higher thickness (* 300 lm compared to * 40 um for untreated feedstock). Improved particle–substrate bonding was evidenced by formation of jets at the particle boundaries